<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<%@ include file="/WEB-INF/views/include/taglib.jsp"%>
<html>
<head>
    <title>住院通知单打印</title>
    <style>
        .table-c table{border-right: 1px solid #0f0f0f;border-bottom: 1px solid #0f0f0f}
        .table-c table td{border-left: 1px solid #0f0f0f;border-top:1px solid #0f0f0f ; text-align: center}
        div{
            text-align: center;
        }
    </style>
    <script type="text/javascript">
        var quarantine = "${liveRequisition.quarantine}";

        if(quarantine == 1){
            document.getElementById("severity").value = "是";
        }else if(quarantine == 2){
            $("#aa").val("111");
            //$("#ordinary").attr("value","1111111");
            //document.getElementById("ordinary").value = "";
        }else if(quarantine == 3){
            document.getElementById("noNeed").value = "是";
        }
    </script>
</head>
<body>
  <div>
     <p style="font-size: 24px;font-weight:bold ">住院通知单</p>
     <p>请注意问患者是否为二次入院，知道病案号请在次填写__________________________</p>
      <hr width="800" style="border: solid 1px"/>
  </div>

  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>姓名:</strong>
      <font face="Courier"><input name="reviewone" value="${liveRequisition.name}"  readonly size="10" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>性别:</strong>
      <font face="Courier"><input name="reviewone" value="${fns:getDictLabels(liveRequisition.sex, 'SEX_DICT', '')}" readonly size="1" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>年龄:</strong>
      <font face="Courier"><input name="reviewone" value="${liveRequisition.age}" readonly size="1" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>出生日期:</strong>
      <font face="Courier"><input name="reviewone" value="<fmt:formatDate value="${liveRequisition.birthdayDate}" pattern="yyyy-MM-dd"/>" readonly size="26" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>职业:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${fns:getDictLabels(liveRequisition.occupation, 'PROFESSION_DICT', '')}" size="15" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>婚姻:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${fns:getDictLabels(liveRequisition.marital, 'MARRIAGE_DICT', '')}" size="5" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>身份证:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.idNo}" size="33" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>出生地:</strong>
      <font face="Courier"><input name="reviewone" value="${liveRequisition.homeplace}" readonly size="78" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>工作单位(写详细):</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.unitInContract}" size="40" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>电话:</strong>
      <font face="Courier"><input name="reviewone" readonly size="15" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>现住址(写详细):</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.address}" size="43" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>电话:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.phone}" size="15" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>联系人姓名:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.contacts}" size="10" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>关系:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${fns:getDictLabels(liveRequisition.contactsRelation, 'RELATIONSHIP_DICT', '')}" size="8" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>地址:</strong>
      <font face="Courier"><input name="reviewone" readonly value="${liveRequisition.contactsAddress}" size="32" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px;border: solid 2px; width: 740px;height: 115px;margin-left:auto;margin-right:auto">
      <div style="margin-top: 20px;margin-left: -600px">
          <span>患者签字栏</span><br/>
      </div>
      <div style="margin-top: 35px;margin-left: -180px">
          <span>以上患者个人情况是否真实？</span><span style="padding-left: 190px">患者或家属签字</span>
      </div>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>入院日期:</strong>
      <font face="Courier"><input name="reviewone" size="38" readonly value="<fmt:formatDate value="${liveRequisition.hospitalizedDate}" pattern="yyyy-MM-dd"/>" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>预交住院费:</strong>
      <font face="Courier"><input name="reviewone" size="20" readonly value="${liveRequisition.acceptingMoney}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>入院时病情:</strong>
      <font face="Courier"><input name="reviewone" size="75" readonly value="${fns:getDictLabels(liveRequisition.hospitalSituation, 'PAT_ADM_CONDITION_DICT', '')}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>门诊诊断:</strong>
      <font face="Courier"><input name="reviewone" size="77" readonly value="${liveRequisition.diagnosis}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>入院科别:</strong>
      <font face="Courier"><input name="reviewone" size="27" readonly value="${liveRequisition.hospitalizedDept}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>病区:</strong>
      <font face="Courier"><input name="reviewone" size="14" readonly style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden" name="newuser" value="yes"><strong>床号:</strong>
      <font face="Courier"><input name="reviewone" size="12" readonly value="${liveRequisition.bedNum}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden"><strong>是否需要隔离:</strong>
      <input type="hidden"><strong>严格隔离:</strong>
      <font face="Courier"><input id="severity"  type="text" size="11" readonly  style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden"><strong>普通隔离:</strong>
      <font face="Courier"><input id="ordinary"  type="text" size="10" readonly  style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
      <input type="hidden"><strong>不隔离:</strong>
      <font face="Courier"><input id="noNeed"  type="text" size="10" readonly  style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>
  <div style="margin-top: 40px">
      <input type="hidden" name="newuser" value="yes"><strong>特别注意事项:</strong>
      <font face="Courier"><input name="reviewone" size="73" readonly value="${liveRequisition.attention}" style="color: rgb(255,0,0);font-size: 18px; border-left: medium none; border-right: medium none; border-top: medium none; border-bottom: 2px solid rgb(192,192,192)"></font>
  </div>

</body>
</html>
